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Suman works as a consultant nurse in intensive care at Frimley Health NHS Foundation Trust and his experience from the past few months tallies with the NIHR findings. 蜜桃直播淚 see patients who were in intensive care and had COVID,蜜桃直播� he says. 蜜桃直播淵ou can蜜桃直播檛 put all of the patients in one category. In my mind, there are three types of COVID patients: those who stayed at home with mild symptoms; those who came to hospital for some treatment; then the third group who were critically unwell requiring intubation and ventilation in intensive care. The way you experience long COVID may depend on which type of patient you are.蜜桃直播�

The way you experience long COVID may depend on which type of patient you are

While a long-term recovery is expected for those who were treated in intensive care, data from the King蜜桃直播檚 study showed that people who had a mild case are more likely to have a range of 蜜桃直播渟trange symptoms蜜桃直播� that come and go over an extended period. The King蜜桃直播檚 team released further research in October showing that older people, women and those who experienced a greater number of symptoms during the first week of COVID-19 were more likely to then develop long COVID.

Caring for long COVID patients

Nursing staff are likely to come across long COVID patients in different settings. Some will encounter patients in the community, others have been working with post-acute COVID patients, who are experiencing severe long-term symptoms following their hospitalisation with the virus. Among the huge range of potential symptoms, two of the most common are fatigue and breathing difficulties.

Patients and families should not be afraid to go back to the hospital or their GP

Suman highlights that the best way to treat this in long COVID patients is still being researched, but there is existing advice nursing staff can draw on. 蜜桃直播淲ith fatigue, the advice you would give to patients is to take things easy: pace yourself, plan your days, focus on nutrition and hydration 蜜桃直播� that is key because if they蜜桃直播檙e feeling very fatigued they might not eat and drink effectively, then you蜜桃直播檙e inviting further illness.

蜜桃直播淥n the breathing side of things, again, we don蜜桃直播檛 know exactly what impact COVID has on patients. If you look at the pathology of the disease, it could be either lung damage causing shortness of breath, or some patients with COVID get pulmonary embolism, a clot in their lungs, and that might still be causing issues for patients and would need to be rectified.蜜桃直播�

Michelle Freeman (pictured above) is Head of Nursing at Remeo Healthcare, which is in a public-private partnership with Guys and St Thomas Hospitals, caring for people with complex respiratory needs. 蜜桃直播淲ith COVID, the symptoms, duration and intensity are so individualised,蜜桃直播� Michelle says. 蜜桃直播淭he key thing as patients come out of acute critical care environments is being able to support and manage post-intensive care 蜜桃直播� these patients are emotionally and psychologically exhausted. Post-viral fatigue is commonplace with so many and when you think about what their body has been through, it蜜桃直播檚 not surprising. It is taking longer for people to recover.蜜桃直播�

Sue Houston is Chief Nursing Officer at Christchurch Group, which is currently providing post-COVID neurorehabilitation services. Sue蜜桃直播檚 multidisciplinary team includes nutrition, speech and language therapy, physiotherapy, occupational therapy, and psychological support. This holistic approach to rehabilitation is crucial, Sue says, but in some cases, patients experience setbacks that hinder this process.

Because of the fatigue and shortness of breath, people are highly likely to experience emotional impacts of the disease

蜜桃直播淲ith some of our post-acute patients, there蜜桃直播檚 been a potential setback on the rehabilitation pathway because of the confusion and fatigue,蜜桃直播� says Sue. 蜜桃直播淲e know that rehabilitation is crucial, but it蜜桃直播檚 whether that individual has enough strength to engage in activities and therapy sessions.蜜桃直播�

For all patients, attending follow-up appointments is vital. 蜜桃直播淧atients and families should not be afraid to go back to the hospital or their GP,蜜桃直播� says Michelle. 蜜桃直播淭hey need those review appointments when they蜜桃直播檙e due. It蜜桃直播檚 really important that they attend those because we don蜜桃直播檛 know how long it蜜桃直播檚 going to last and we don蜜桃直播檛 know all of the after-effects.蜜桃直播�

Mental health

Nursing staff should also be aware of the psychological impact of COVID-19 and long COVID. In November, an analysis from the University of Oxford and NIHR showed that nearly one in five people who蜜桃直播檝e had COVID-19 were diagnosed with a psychiatric disorder within three months of contracting the virus. COVID patients were twice as likely to receive a mental health diagnosis than flu patients.

蜜桃直播淏ecause of the fatigue and shortness of breath and the experience they had in hospitals, people are highly likely to experience emotional impacts of the disease, so it蜜桃直播檚 really key that they keep talking to family and friends, particularly if they蜜桃直播檙e living by themselves, and also try to do things that they enjoy to keep them in a positive mindset,蜜桃直播� says Suman. 蜜桃直播淭hat蜜桃直播檚 really important. If you lose your motivation, it will be very difficult to get over that fatigue and shortness of breath. Encourage patients, if mood is an issue, to seek psychological support.蜜桃直播�

Michelle and Sue have also observed the mental health impact of COVID-19. 蜜桃直播淲e蜜桃直播檝e started putting into place psychological first aid in the context of COVID-19 蜜桃直播� that蜜桃直播檚 about delivering care in aftermath of emergencies, including infectious disease outbreaks,蜜桃直播� says Michelle. 蜜桃直播淲e need to consider the fear around not knowing what those longer-term outcomes might be. Everything you do, you have to take into account the emotional and psychological wellbeing of patients.蜜桃直播�

The unique challenges of COVID-19 lockdown may also have contributed. 蜜桃直播淎nother thing that蜜桃直播檚 had a profound effect is the restrictions on visitors,蜜桃直播� says Sue. 蜜桃直播淚 don蜜桃直播檛 think we can underestimate the emotional and mental pressure that蜜桃直播檚 put on.蜜桃直播�

Learning and training

Right now, the most important thing that nursing staff can do is be aware of long COVID and the different forms it may take so you蜜桃直播檙e ready to offer patients the best care when they need it.

Talking to patients and explaining to them what COVID is, is really important

蜜桃直播淭raining and learning are the most important things for nurses out there,蜜桃直播� says Michelle. 蜜桃直播淕et onto those webinars and online learning sessions, listen to other health professionals and hear about what蜜桃直播檚 happening in other areas of the country and the world.蜜桃直播�

For senior nursing staff, sharing knowledge with your team is crucial, says Sue (pictured below): 蜜桃直播淟ike with sepsis, you get a lot of differential diagnosis and overshadowing [with long COVID], so it蜜桃直播檚 about educating staff so that it transfers into their practice and giving them a safe forum to talk about it. We almost need post-COVID syndrome [to be recognised] so you can educate staff and ensure they蜜桃直播檝e got that knowledge and empathy.

蜜桃直播淲hen someone says 蜜桃直播業蜜桃直播檓 exhausted蜜桃直播�, you蜜桃直播檝e got to know what that actually means 蜜桃直播� it蜜桃直播檚 not tired, it蜜桃直播檚 exhaustion from this condition. You蜜桃直播檝e got to know the difference and build that into their care plan and risk assessment. Recovery isn蜜桃直播檛 just about the rehab and nursing care, it蜜桃直播檚 about the body healing itself as well.蜜桃直播�

Suman is part of the multidisciplinary team that runs post-intensive care rehabilitation sessions to monitor patient progress, as well as specific physiotherapy sessions for post-COVID patients. Suman uses these sessions to talk to patients about COVID-19 and the ongoing effects they may be experiencing. 

He says: 蜜桃直播淲hat I蜜桃直播檝e learned in the past few months is that talking to patients and explaining to them what COVID is, is really important. When I explain to them the pathophysiology of the lung, for example, they understand why they蜜桃直播檙e short of breath, why they蜜桃直播檙e tired, why they蜜桃直播檙e feeling low. That has been really helpful. I蜜桃直播檇 advise hospitals to set up those kind of groups and services.蜜桃直播�